BEUDAMED
    FDA Adverse Event Injury Summary report: N

    NOVATION

    MDR report key: 8948266 · Received August 29, 2019

    Report

    Report Number
    1038671-2019-00431
    Event Type
    Injury
    Date Received
    August 29, 2019
    Date of Event
    August 1, 2019
    Report Date
    December 13, 2019
    Manufacturer
    EXACTECH, INC.
    Product Code
    JDI
    PMA / PMN Number
    K070479
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SP
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 0

    THE ENGINEERING EVALUATION NOTED IN THE EXPERIENCE REPORTED THAT THE PROSTHESIS WEAR WAS LIKELY THE RESULT OF THE ANTEVERSION OF THE CUP AND OFF-LABEL STEM IMPLANTED, WHICH APPEARS TO HAVE LED TO POSTERIOR IMPINGEMENT AND SUPERIOR SUBLUXATION. HOWEVER, THIS CANNOT BE CONFIRMED AS THE DEVICES HAVE NOT BEEN REVISED, AND THEREFORE, HAVE NOT BEEN RETURNED TO EXACTECH FOR EVALUATION. ¿EXCESSIVE WEAR OF THE IMPLANT COMPONENTS SECONDARY TO IMPINGEMENT OF COMPONENTS OR DAMAGE OF ARTICULAR SURFACES¿ IS LISTED IN THE PRODUCT LABELING UNDER DEVICE SPECIFIC RISKS. CONCOMITANT MEDICAL DEVICE(S): (CN: 180-11-52, SN: (B)(4)) NV CROWN CUP CLSR HL W/HA 52 GROUP 2.

    Additional Manufacturer Narrative · 1

    PENDING EVALUATION. CONCOMITANT MEDICAL DEVICE(S): (CN: 180-11-52, SN: (B)(4) NV CROWN CUP CLSR HL W/HA 52 GROUP 2.

    Description of Event or Problem · 1

    PREMATURE WEAR OF POLYETHYLENE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    738304 NOVATION NV GXL LNR, LIPPED 32MM ID GROUP 2 CUPS JDI EXACTECH, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 Other